The Covid-19 public private partnership has been a rehearsal for a better future

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The onset of Covid-19 has been proof that a collaborative approach between private and public sector can lead to a successful NHI, which would be a useful tool to help diagnose, treat and control the spread of all diseases more effectively. Picture: Supplied
The onset of Covid-19 has been proof that a collaborative approach between private and public sector can lead to a successful NHI, which would be a useful tool to help diagnose, treat and control the spread of all diseases more effectively. Picture: Supplied

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Before the Covid-19 pandemic, the National Health Insurance (NHI) was high on South Africa’s healthcare agenda, but once the virus attacked, we realised very quickly that our healthcare systems were somewhat unprepared for the magnitude and speed of a pandemic’s spread.

However, with collaboration, and sound decision-making, we have been able to deal as effectively as possible with the crisis.

In fact, South Africa was expected to be hit the most by Covid-19 in Africa , ranking 1st out of 10 countries and surpassing larger populations such as Egypt and Nigeria, but our effective Covid-19 response brought us great relief.

It is encouraging to note that the public and private healthcare sectors have worked together closely, and they appear to have cooperated successfully.

The public private partnership during Covid-19 may well have laid the foundation for a better healthcare system and paved a roadmap for a successful NHI in the years to come. 

How ready are we for NHI?

The concern is still whether the public sector is ready for NHI, given the unknown costs of it and the yet to be defined benefit package.

There have been talks of a proposed taxation, but this would not be enough, given the high unemployment rate in South Africa and an already constrained taxpayer base.

Every year approximately R450 billion is spent on healthcare, of which about R225 billion is spent for 85% of the country's population who make use of the public sector, and the remaining R225 billion is spent by 15% of the population on private healthcare.

This is a highly unequal distribution, and arguably an inefficient healthcare system which requires re-engineering through collaboration, cooperation and innovation.

In a constrained healthcare environment, private sector plays a critical role to ease the heavy burden that exists in state facilities.

Medshield Medical Scheme, through our innovative and value-based plans, has made a conscious effort to ensure affordability to its members thereby ensuring that we include as many people as possible.

What we found at Medshield was that during the pandemic there has been an increase in Covid-19 related costs especially at the initial outbreak due to testing – most of which was voluntary – and hospitalisation for the treatment of cases.

In current economically challenging climate, Medshield is standing by our members and supporting them by announcing an affordable 5.9% weighted contribution increase for 2021.

True to our beliefs and commitment to our members, we’ve chosen to pass the expected R400m surpluses generated in 2020 back to our members through low increases for 2021, ranging from an affordable R84 increase on our entry level plan and up to R350 increase on our top end plan. These are the lowest contribution increases in the last 10 years of Medshield’s history.

Healthcare is a right, which is enshrined in our constitution and the reality is that NHI is absolutely necessary in South Africa. The concept of universal healthcare is not new and in fact, the ANC manifesto in 1994 which addressed Social Security reform  included elements of the introduction of a national health insurance scheme for equitable and affordable access to healthcare for all South Africans.

The onset of Covid-19 has been proof that a collaborative approach between private and public sector can lead to a successful NHI, which would be a useful tool to help diagnose, treat and control the spread of all diseases more effectively.

A positive side to the pandemic

What we found at Medshield was that during the pandemic there has been an increase in Covid-19 related costs especially at the initial outbreak due to testing – most of which was voluntary – and hospitalisation for the treatment of cases.

Other healthcare costs decreased and as I detailed in a previous article earlier this year, we saw a change in patient priorities, with patients choosing to defer elective surgical procedures, opting out of routine check-ups with their doctor, and an overall reduction in hospital admissions. In general, medical schemes have experienced an average 20% fewer claims this year than budgeted for.

At the end of 2019, Medshield had a solvency ratio well above the statutory 25%, sitting at almost 40% and with more than R1.9 billion in reserves to ensure our members are financially protected through the pandemic, and well into 2021 and the foreseeable future.

The high solvency ratio reflected a strong claims-paying capability as confirmed by the Global Credit Ratings Agency (GCR) awarding of the Scheme’s AA- rating, for the fourteenth consecutive year.

This status allows Medshield to offer lower increases on member contributions across their benefit options, whilst providing the assurance that Medshield is financially stable and their members’ claims will be paid.

As medical schemes, we have the responsibility to ensure our members are well taken care of no matter where they are referred to and having more options for our members would mean we would be able to support more citizens.

With this in mind, the private healthcare sector is ready to support the public sector on the journey towards universal healthcare and NHI implementation. Close collaboration between the sectors during the pandemic ensured that as South Africans, we  managed to attend to every patient that needed immediate care, and if we take that collaboration into NHI, coupled with strong policies for working, and transparent honest leadership, we can expect a better healthcare future for all.

Although the quality of healthcare in the public sector has always been a major concern, Covid-19 has brought this into the spotlight. The pressure forced the public healthcare sector to raise their standards to ensure that people were treated in a unique and acceptable way.

This is not to say that the healthcare professionals in the public sector are not competent – in fact all healthcare professionals are trained in the public sector before some choose to move to the private sector.

The infrastructure in public healthcare is severely under maintained and lags the private sector, however the pandemic has helped with recapacitating and preparing better infrastructure. This will reinforce trust and assurance in the entire healthcare sector which our citizens are seeking especially in these uncertain times.

Let the partnership continue

On our end, Medshield launched the Live Assured campaign which is about creating certainty, providing assurances and comfort so that members can feel more at ease and focus on enjoying their lives and not to stress about their healthcare needs, as Medshield has them covered.

Live Assured promises to deliver even greater access to member-centric quality healthcare during these highly uncertain times. Free 24/7 trauma and counselling benefit across various platforms, loyalty programmes, and at-home exercise routines for members are some of the added benefits we have rolled out to ensure enhanced member value.

Universal healthcare is the only direction and the unfolding of the NHI Bill is one of the key steps towards this equal society. The Health Market Inquiry (HMI) highlighted the need for a basic benefit package for all SA citizens.

As medical schemes, we have the responsibility to ensure our members are well taken care of no matter where they are referred to and having more options for our members would mean we would be able to support more citizens.

We must overcome the challenges of corruption, collaborate and find a way to unlock a more equitable healthcare future for all South Africans.

. Thoneshan Naidoo is the principal officer of Medshield Medical Scheme


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